Diseases exam 4 Review

Could a precipitating factor for asthma in pediatric patients be viral?

yes

What is status asthmaticus?

The failure to respond to bronchodilator therapy

Could GERD be a trigger for asthma?

yes

A patient with severe asthma presents with audible wheezing, a normal CO₂ and a decreased PO₂ what should be anticipated?

Impending respiratory failure

What happens during the early phase of an asthma attack?

CO₂ is blown off, then the patient starts getting tired

As an asthma attack progresses and the patien becomes fatigued, what occurs?

CO₂ increases

Disappearance of wheezing with diminished air movement indicates

Severe airway obstruction

What is the purpose of a peak flow meter?

To measure peak expiratory flow rate

A peak flow meter reading below what percentage indicates the need for hospital evaluation?

50%

After administering albuterol, what improvement in peak flow is expected?

20%

Acute bronchitis refers to:

short term inflammation

chronic structural changes in the bronchi are characteristic of ?

Chronic bronchitis

destruction if the AC membrane is a characteristic of?

emphysema

Destruction of alveoli results in?

decrease surface area

Why do emphysema patients have increased lung volumes?

because of a decrease elastic recoil

Which breathing technique helps reduce airway collapse in COPD patients?

pursed lipped breathing

typical chest x ray findings in COPD patients

Flattened diaphragm and elongated heart

animal dander is classified as which asthma trigger?

extrinsic

cystic fibrosis is classified as what type of disease?

obstructive

first line medication for acute asthma exacerbation

a bronchodilator such as albuterol

what device improves delivery of MDI medications?

the use of a spacer

in an emergency asthma exacerbation, which is preferred?

IV corticosteroids

Which diagnostic tools helps assess severeity of acute asthma exacerbation

A peak flow meter

Peak flow meters measures?

peak expiratory flow rate

After giving an A&A treatment, the patient’s HR becomes normal, RR decreases, and SpO₂ improves. What does this indicate?

A positive response to treatment

Should your clinical assessment be used instead of relying on ABGs?

yes you would want to look at the patiens’s vitals, and work of breathing

What clinical signs indicate improved work of breathing?

Decreased RR and reduced accessory muscle use

Definitive treatment option for advanced cystic fibrosis patients?

Total lung transplant

a major complication after lung transplant

the need for lifelong anti-rejection therapy

common non-respiratory manifestation of cystic fibrosis

Sinusitis

What chromosome is affected in cystic fibrosis

Chromosome 7

what is characteristic of sputum in bronchiectasis

Copious, thick, purulent

Bronchiectasis can lead to signs such as JVD, pitting edema, and hepatomegaly due to ?

Cor pulmonale ( right sided heart failur)

Chest x ray during an asthma excerbation may show

Flattened diaphragm and hyperinflation

What will the chest X-ray of a stable asthmatic most likely appear?

normal

What is commonly found in sputum of asthma patients?

Charcot-leyden crystals

typical finding in chronic bronchitis patients

purulent sputum

CO₂ levels in chronic bronchitis are typically?

increased

Which PFT value is most important in diagnosing COPD?

FEV₁/ FVC ratio (FEV₁%)

COPD is indicated when FEV₁/FVC is?

< 70%

Common symptoms of asthma include?

Wheezing, coughing, chest tightness

Is a fever common in asthma?

NO

Exhaled nitric oxide levels > 50 indicate

airway inflammation in asthma

Ventilatory failure is characterized by?

Low pH, high CO₂ , normal or slightly increase HCO₃ -

Does bicarb change quickyl in acute ventilatory failure?

No

In ventilatory failure, what happens to oxygenation (SaO₂)

Decreases

Which diagnostic tests are useful for bronchiectasis?

Chest x ray, sputum culture, ABG, CBC

in bronchiectasis which CBC falues are important to monitor?

RBC and hemoblobin

Why are RBC, hgb, and HCT increased in in bronchiectasis/ COPD?

Because of polycythemia due to chronic hypoxia

yellow- green sputum in bronchiectasis most likely indicates

Bacterial infection such as psudomonas

Hallmark sign of bronchiectasis

Copious amount of thick purulent sputum

Do cystic fibrosis patients experience hyperinflation

Yes

Why does hyperinflation occur in CF patients

Because its an obstructive disease they’re air trapping

CF sputum is best described as

Thick, tenacious

Dornase alfa works by breaking down

DNA

Mucomyst breaks down

Disulfide bonds

Why are males with cystic fibrosis typically sterile?

Absence of vas deferens

if both patients are carriers of CF, what is the chance the child will ahevthe disease?

25%

If one parent has cystic fibrosis and the other parent is a carrier, what is the probability that their child will have cystic fibrosis?

50%

Anatomic alterations in chronic bronchitis include:

submucosal gland enlargement and airway remodeling

does chronic bronchitis destroy the AC membrane?

No that would be emphysema

pathologic changes in emphysema include

Destruction of the AC membrane

Surface area for gas exchange in emphysema is?

decreased

Emphysema is associated with

a dry cough

does emphysema patients have air trapping and hyperinflation?

yes they are obstructive patients

does emphysema patients have weakened respiratory bronchioles?

yes of course because of their cough

A paitent with COPD they should get their BI-annual flu shot?

No, it’s only annual once a year!

Appropriate COPD management includes?

Smoking cessation, bronchidilators, bronchopulmonary hygiene

Glod standard test for diagnosisng CF includes?

Sweat test

What is elevated in a CF sweat test?

Chloride

Genetic testing for CF is recommended for?

Parents/ carriers in. the early stages. and IRT

Which vitamins are patients with CF most likely to be deficient in?

K, A,D,E

Why do cystic fibrosis patients develop fat soluble vitamin deficiencies?

Inadequate enzyme production for fat digestion

Which characteristic describes the stool of cystic fibrosis patients with pancreatic enzyme deficiency?

Slippery stool

which macronutrients are most difficult for cystic fibrosis patients to digest?

protein and fat

true or false antibotics are often used in CF to help manage lung infections

True

true or false antitussive medications are recommended for cystic fibrosis patients?

false you want the patient to cough

What is the purpose of expectorants in CF management?

To thin out the secretions

A 2-year-old presents with chronic wheezing after choking on food 6 months ago. Imaging shows bronchiectasis. What is the most likely cause?

foreign body aspiration

which of following should be included in a COPD assessment

Degree of airflow limition and Impact of COPD on health status

Which is a non-pharmacologic treatment for COPD?

Pulmonary rehabilitation and activity promotion

True or false Cystic fibrosis patients have a tendency to develop status asthmaticus.

False two different diseases

Which of the following is a classic neonatal sign of cystic fibrosis?

meconium ileus

True or False CF patients typically have excessive and viscous pulmonary secretions.

True

When managing a CF patient as a respiratory therapist, which intervention is recommended?

Postural drainage, encourage coughing and airway clearance, percribe long-term antibiotic

Pulsus paradoxus is most closely associated with which diseases?

Asthma

Chronic cough for 2 months in the last 2 consecutive years is typically associated with

Chronic bronchitis

Which population has the highest prevalence of cystic fibrosis?

white people

true or false CF is caused by a single mutation in the CFTR gene

False

true or false CF is the most common fatal childhood inherited disorder?

true

Which combination of drugs causes bronchial smooth muscle relaxation in asthma?

Sympathomimetic + parasympatholytic

Can CF patients be managed long-term by diet alone?

No, lifelong digestive enzyme supplementation is required

CF patients have abnormal secretions from exocrine glands which reproductive effect is common?

Women: thick uterine/ fallopian mucus

men: loss of vas deferens

long term airway inflammation can lead to

airway remodeling

which of the following are common complications in chronic bronchitis patients?

Bronchiectasis, cor pulmonale, digital clubbing

When managing a CF patient, which is the correct sequence of interventions?

1. Bronchodilator

2. Mucolytic

3. CPT (chest physiotherapy)

4. Antibiotic

1. bronchodilator

2. mucolytic

3. CPT

4. antibiotic

Panlobular emphysema is most commonly caused by:

alpha -1 antitrypsin deficiency

Which of the following is a common cause of emphysema

smoking, occupational exposure, Alpha 1- antitrypsin

Does inhaling asbestos fibers cause emphysema

No it causes pulmonary fibrosis

For asthma patients, what is the expected change in FEV₁ after bronchodilator treatment to indicate reversibility?

12%